Eye of the needle.

• Position: UPFRONT

Scars fleck my flesh. Many were inflicted by folly, like the now nearly invisible one at the corner of my right eye, etched when I toppled into a toy box as a toddler. (A man's reach should, indeed, exceed his grasp but not a 1-year-old's.) Others, more precise, linger where scalpels once sliced skin. That both my hands don't bear these in abundance is a testament to a surgeon's curiosity, compassion and skill, but they make a mockery of the economics underlying American medicine.

Among the afflictions I'm heir to is one called Dupuytren's contracture, which causes the fascia, a layer of tissue just beneath the skin of the palm, to harden and shrink, forming lateral cords that keep the fingers, especially ring and pinkie, from straightening. Eventually they bend, curling like claws. Rarely painful, it's not malignant, but if you make a living with your hands--or as I'm doing now, pecking a keyboard--it becomes a major pain in another part of your anatomy. Even putting your hand in your pocket can be a trial.

Standard surgery involves cutting open the palm to excise the fibrous tissue. This not only requires stitches, splints and postoperative therapy but risks complications such as infection and nerve damage. Because there is a 50/50 chance the nodes will grow back, the resulting scar tissue makes another fasciectomy even more difficult. The first hand surgeon I consulted cautioned me to wait. Over the course of a decade, I watched my fingers--first on my left, then my right--tick down like the minute hand on a clock as the quarter-hour approaches.

Prowling the Internet, I read everything I could find about Dupuytren's. That's how I learned about needle aponeurotomy. Pioneered by a rheumatologist in Paris, the procedure is performed by few doctors in this country. Simply put, it involves poking a small-gauge hypodermic needle into the cords, fraying them until they can be snapped by straightening the fingers. A clinic in West Palm Beach, Fla., was not only doing it but...